MAIL/FAX ORDER FORM... (Please use this form only if you are going to mail or fax your order to Jevin Enterprises, Inc.. We recommend that you print it out and then browse the site.) MAIL ORDERS TO: FAX ORDERS TO: Coast Dance Shoes 551 Jessie Street. San Fernando, CA 91340 1-818-408-0585 Order by: Credit Card Style Color Size/Width Heel Special Price                                                                         Shipping - within US: 1st pair: $7.75 Sub Total   $1.25 for each additional pair Shipping   Sales Tax (CA 8.25%)   Sizes available: [ Men: 4 to 15 ] - Women: [ 2 t0 12 ] Total   Additional comments or requests: _________________________________ __________________________________________________________ Thank You! Checks, Money Orders, Or Cashier's Checks Please make payable to: Jevin Enterprises, Inc.. Checks must be in US Dollars and be encoded at the bottom of the check. Credit Cards Billing Information (US Orders Only) Name as on Credit Card Billing Street Billing City, State, & Zip Code Billing Phone Number Credit Card Number Expiration Date Signature Code number on back of credit card Email Address Email Your Questions to: Jevin Enterprises, Inc..